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Column: With long-term, who will take care of you?

BY MICHELLE SINGLETARY Columnist

Sep 8 2013 12:01 am

Editor’s note: This is the fifth column in an occasional series from Washington Post financial columnist Michelle Singletary about the Patient Protection and Affordable Care Act, commonly referred to as Obamacare.

I attended Bishop T. D. Jakes' MegaFest conference over the Labor Day holiday weekend in which I participated on a panel about faith, family and finances.

During the discussion, a woman asked a question that so many others are asking. She wanted to know what to do about her aging parents. They have little money and many health issues. She didn't think they could continue to afford living on their own. The woman is sandwiched between taking care of her children and her parents. Her financial resources can stretch only so far.

“I am at a loss,” she said.

The fact is, her options are limited. We've been spending a lot of time lately talking about the Affordable Care Act, but there are many people like this woman's parents, even if they have health insurance, who will still fall short of the care they need. Under the Act, there are provisions for states to expand Medicaid to help people receive long-term care services and support in their home or the community. But what if you aren't poor enough to qualify for Medicaid?

As part of health care reform, there is now a federal Commission on Long-Term Care, which is charged with coming up with a comprehensive plan by the middle of September to address the availability and financing of long-term services and support systems for seniors and disabled Americans. But until such services and systems exist, what are your options?

Unfortunately, you are pretty much on your own.

Surveys continue to show that many people are unprepared for the cost of a prolonged illness, especially in their senior years. Medicare generally does not cover long-term care services, which include assistance with daily activities such as eating, dressing and bathing, or help with someone who has a severe cognitive impairment such as Alzheimer's disease. Without long-term care insurance for her parents, which can cover the cost of nursing homes, assisted-living facilities and in-home care, the woman and her husband will largely have to rely on their own funds.

I wish I had a better answer for her. But I encouraged her to think about what she was going through and prepare for the day when her children are faced with the same issue.

Really, that's the message of a recent report “The Aging of the Baby Boom and the Growing Care Gap” by the AARP Public Policy Institute. As the population of older people increases over the next 20 years, the number of adults in their primary caregiving years (ages 45 to 64) is projected to remain flat. This means the availability of family caregivers – mostly adult children – to arrange, coordinate, provide and/or pay for long-term care services is expected to decline.

However, more than two-thirds of Americans believe that they will be able to rely on their families to meet their long-term care needs.

“The future looks very unlike the past,” said Lynn Feinberg, AARP senior policy adviser and one of the report's authors. “We have more women in the workforce who are juggling caregiving and work. There are a greater number of people living at a distance. There is huge number of people who don't have any living children. We have to look at public as well as private community solutions to long-term care.”

The AARP report is a cautionary tale for today's caregivers and other midlife individuals. You may be caring for your mom or dad now, but who will care for you? “Boomers who are the large cohort of caregivers have to start thinking ahead as they are providing care,” said Donald Redfoot, AARP senior strategic policy adviser and co-author of the report.

To help you plan for your long-term care needs, AARP has created a 40-day challenge called “Decide. Create. Share.” Although it is geared toward women in their 40s, 50s and 60s, men should join in too. Go to www.decidecreateshare.org and take the pledge.

There are seven steps over the course of 40 days. The site has a target date to finish by Oct. 13, but go ahead and start when you can. You'll get email reminders outlining the things you have to do, such as telling people where you keep your important documents. You can download a worksheet that guides you though the information you'll need to provide. There's a long-term calculator that lets you see the average cost of long-term care in your state.

I've been the long-term caregiver for several relatives. Because I know the toll it takes, I've taken a personal pledge to put in place a plan to make it easier for my children to take care of me. Isn't it time you decide, create and share your plan?

Michelle Singletary is a personal finance columnist for The Washington Post.

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